Remaniements expérimentaux et pathologiques de la jonction neuromusculaire

End-to-side neurorrhaphy using an electrospun PCL/collagen nerve conduit for complex peripheral motor nerve regeneration

In cases of complex neuromuscular defects, finding the proximal stump of a transected nerve in order to restore innervation to damaged muscle is often impossible. In this study we investigated whether a neighboring uninjured nerve could serve as a source of innervation of denervated damaged muscle through a biomaterial-based nerve conduit while preserving the uninjured nerve function. Tubular nerve conduits were fabricated by electrospinning a polymer blend consisting of poly(ε-caprolactone) (PCL) and type I collagen. Using a rat model of common peroneal injury, the proximal end of the nerve conduit was connected to the side of the adjacent uninjured tibial branch (TB) of the sciatic nerve after partial axotomy, and the distal end of the conduit was connected to the distal stump of the common peroneal nerve (CPN). The axonal continuity recovered through the nerve conduit at 8 weeks after surgery. Recovery of denervated muscle function was achieved, and simultaneously, the donor muscle, which was innervated by the axotomized TB also recovered at 20 weeks after surgery. Therefore, this end-to-side neurorrhaphy (ETS) technique using the electrospun PCL/collagen conduit appears to be clinically feasible and would be a useful alternative in instances where autologous nerve grafts or an adequate proximal nerve stump is unavailable.

The Study of Myogenin Expression in Denervated Human Skeletal Muscles

Skeletal muscle denervation eventually causes atrophy as a result of interrupted nerve conduction and the lack of nutritional factors. Myogenin is a myogenic regulatory factor that plays a key role in myoblast differentiation. Changes in myogenin expression in denervated rat skeletal muscle have been demonstrated, but myogenin expression in denervated human skeletal muscle has not been reported. Human muscle samples were analysed at different time-points post-denervation to evaluate changes in myogenin expression and their relationship with skeletal muscle atrophy. Post-denervation, myogenin mRNA levels peaked at 7 months and were 37.5 times the normal level. Expression levels then declined to 21 and 11 times the normal level at 12 and 26 months post-denervation, respectively. Prolonged denervation resulted in pathological changes characterized by decreased numbers of intact muscle fibres.